- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $3,019.95 / $7,762.47
| Facility | | $186.21 | $3,019.95 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $257.04 / $645.65
| Professional | | $123.03 | $257.04 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,786.30 / $9,549.93
| Facility | | $2,630.27 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $257.04 / $630.96
| Professional | | $204.17 | $257.04 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $1,698.24 / $6,165.95
| Facility | | $165.96 | $1,698.24 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $165.96 / $380.19
| Professional | | $165.96 | $165.96 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $1,819.70 / $53,703.18
| Facility | | $204.17 | $1,819.70 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $371.54 / $977.24
| Professional | | $147.91 | $371.54 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $158.49 / $398.11
| Facility | | $123.03 | $158.49 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $389.05 / $549.54
| Professional | | $288.40 | $389.05 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $346.74 / $575.44
| Professional | | $194.98 | $346.74 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $50,118.72 / $75,857.76
| Facility | | $131.83 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $389.05 / $575.44
| Professional | | $316.23 | $389.05 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $3,548.13 / $7,244.36
| Facility | | $1,862.09 | $3,548.13 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $275.42 / $676.08
| Professional | | $104.71 | $275.42 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $128.82 / $436.52
| Facility | | $97.72 | $128.82 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $323.59 / $630.96
| Professional | | $194.98 | $323.59 | $630.96 |